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Transformations Issue 8 - April/May/June 2013

 
 

TRANSFORMATIONS

from the office of

Christopher Emerson, Ph.D

April/May/June 2013 Issue No. 8  
Palm Springs View

 

 

Welcome to our 8th edition of TRANSFORMATIONS.  In this issue, guest author Claudia Lewis, M.A. discusses the effects of trauma on relationships, Dr. Katie Barnes explores strengths-based work in therapy, and I share some thoughts about the process of change and growth and how psychotherapy can help facilitate these processes in all areas of our life.

 

Thank you to practice administrator Dylan Maddalena for his help in assembling and editing this issue of TRANSFORMATIONS.  Dr. Katie Barnes is currently accepting new patients, and is often willing to work on a sliding fee scale. I am now seeing patients in my Los Angeles office as well as in my Palm Springs office, with appointments available on weekends and Mondays until 12pm. The address is 1900 E. Tahquitz Canyon Way, Suite C-3, Palm Springs, California. Prospective patients can reach me at the office phone number, 310-550-4560, or on my mobile phone at 213-220-1794.  Thanks for reading - as always, we welcome your thoughts, inquiries, comments, and questions. 

 

 

 

 

Dr. Chris Emerson

The Violation of Human Connection: 

How Trauma Impacts Human Relationships

 

By Claudia Lewis, M.A.

 

Claudia Lewis, M.A., MFT

Relating is an integral part of being human. Intimate relationships, friendships, family and community are an essential element of our well-being. We know that when an individual lives in isolation, his emotional state, mental health and very survival are called into question.

 

After someone experiences a trauma, relationships are crucial as the person tries to figure out what has happened and to make sense of how the world feels and looks like a different place. The alarming reality, however, and one of which many are not aware, is that the experience of trauma itself calls into question basic human relationships, causing turmoil at the time that relationships are needed the most.

 

Why is this? First, it is helpful to define trauma. Nowadays, it has become a household word, thrown around in instances that are not truly traumatic. In essence, trauma is any experience in which we feel as if our survival has been threatened. When most people think of trauma, rape, war, child abuse and car accidents come to mind. These are all classic examples of trauma. Additionally there exists cumulative trauma - experiences over the course of time such as poverty, addiction or living in a world that rejects us for appearing different. In short, trauma has many faces.

 

When considering how trauma shatters trust in relationships, we must begin by going back to infancy. As babies, we learn about and form a basic level of trust with our primary caregivers. This trust sustains us as we move through life, so that despite the inevitable disappointments and vagaries, we generally feel supported and are able to bounce back. When we experience a trauma, in our terror we reach out to be saved, crying for our parents, partners or God to save

us. When this help does not come, our fundamental trust becomes fragmented.

 

What does this mean? For a deeper level of understanding, let us first look at the instinctual hierarchical neurobiological response inherent in all of us. The most ancient mechanisms,

coming from the basic part of our brain prepare us to either fight our foe, or flee - and if either of these fail, to freeze, possum-like, in an effort to remain unseen. We have known about this physiological response for some time. Scientists are now theorizing* however, that as mammals we have also developed a more sophisticated primary response to threat: at the top of the hierarchy and as a first line of defense, is the propensity to engage with our environment in an effort to resolve threat and ensure calm. We may first engage by reasoning, cajoling or pleading. This can be seen most readily in infants who grimace or cry to signal distress, as they do not have the ability to fight or flee. When, at the time of a perceived threat, that social engagement falls on deaf ears, two things happen: we drop down to our next line of defense in the hierarchy (fight or flight) and our basic trust of human relationships disintegrates.

 

A number of impactful results occur when our trust dissipates in this way: the loss of control experienced during the trauma results in a violation of autonomy, thereby destroying the belief that person has in the capacity to be herself with others; the trauma leaves the person prone to shame (a response to helplessness) and doubt (questioning the ability to be separate while in connection with others); the capacity for competence and initiative is lost, leading to guilt and inferiority. These effects result in an assault on the person's self-esteem and with it, a mistrust of community and difficulty with intimacy. Intrusive memories, nightmares and systemic dysregulation impinge on the survivor, compounding the issue. At the time when we need others most, the person who has experienced a trauma finds himself cut off from the life line of community and relationships. Traumatized people desperately desire relationships and at the same time withdraw. The painful relational pattern that ensues is isolation alternating with an anxious clinginess. These fluctuating relationships are often seen along a spectrum after a trauma, and especially in the diagnoses of PTSD, attachment disorders and Borderline Personality Disorder. Of course, what is especially distressing for trauma survivors, is that the dialectic of trauma extends beyond their inner lives, and into their relationships.

 

How do these trauma effects resolve? We are wired in such a way that when we suffer or witness a trauma, our experience becomes locked into the mid brain (amygdala) - nature's way of guaranteeing that we will recognize the trauma should we meet it again. This was appropriate thousands of years ago when encountering a dangerous wild beast threatened our survival. But in modern times, this freezing of traumatic experience results in the traumatized person being at the mercy of often unpredictable triggers that will set off a hyper-vigilant nervous system. Accordingly, the brain unwittingly re-enacts the trauma in a vain attempt to process it and release it. A classic example of this is the soldier returned from a war zone, who startles at even the smallest noises and must sleep with a gun close by. His spouse feels as if she is walking on egg shells and is baffled by how she can help him.

 

This painful and isolating conflict can be addressed through therapy by reprocessing the trauma, putting the trauma in context and perspective and through rebuilding of the self. For those who interact with trauma survivors, the behaviors they exhibit appear confusing, unpredictable and distancing. Intimate partners often feel hurt and rejected, which is in conflict to their desire to support their partner. An important part of getting a relationship back on track is for the partner and the survivor's family to understand the devastating effects that trauma typically wreaks. With the right care and approach, the traumatized person can be healed, and intimate and family relationships saved.

 

*Primarily Stephen Porges' Polyvagal Theory

 

The source of this article is 

'Trauma and Recovery'

by Judith Herman, M.D., Basic Books 1992 

 

 

Claudia Lewis, M.A., MFTi is in private practice under Julie De Santo, LMFT. She is fully trained in EMDR and specializes in treating trauma. EMDR is an effective modality for treating trauma. You can find out more about what she does at www.claudialewistherapy.com
8425 W.3rd ste 309, Los Angeles, CA 90064
310.461.8662

 

 

 

A Strengths-Based Approach: 

To Therapy and Life

 

by Dr. Katie Barnes


Dr. Katherine Barnes Headshot

 

 

We see the Facebook re-posts and receive the chain emails in our inboxes almost daily-"Be Grateful to just be alive, for someone else somewhere is struggling just to survive," "Count your blessings," or "You must love yourself before you can love another."  The emphasis on Self Love or Acceptance is abundant, and perhaps there is something to be said for focusing on the positive in one's life as opposed to fixating on the problematic areas. 

 

As a clinician, one aspect of therapy I struggle with is the question of "how much grieving (be it, focusing on problems, self-loathing, etc.), is healthy?"  Is this person seeking a diagnosis so that they can be a victim and perpetuate a cycle of victimization in their life, or is this amount of "grieving" necessary in order for them to be able to eventually move on from the problem? 

 

While a balance of grieving and "moving on" does need to be reached, I've recently found myself more in favor of the first probability.  While many patient-specific factors play into my appraisal, I have found that a Strengths-Based approach to therapy (and thus, to our lives in general), is ultimately a healthy and mobilizing one. 

 

Most people come to therapy to change something in their lives, and they recognize that in order to change, it needs to come from within.  However, if we maintain that we are sick, have a debilitating mental illness or are otherwise incapable of the change, we simply will not change.  The Strengths-Based approach places focus on what's going right in a person's life. Instead of focusing the conscious mind on the bad, the sad and the ugly, if we are to focus instead on what is good, right, and what we are capable of, we may be more inclined to adjust our thinking and our actions this way. 

 

It also seems that "successful" or "happy" people tend to be Strengths-Based intuitively, as do many therapists in their practices.  Many exercises exist placing emphasis on Self Love/Acceptance, such as, "Name 10 things you like about yourself," or "List 3 things you can and will do today to take action toward your goal."  Life Coaching, for example, is very Strengths-Based. 

 

Whereas it is completely therapeutic to authentically allow catharsis to occur in therapy and in life-letting the negative out along with the positive-it may be also in our interest to be more mindful of our strengths.  Or, if we at least do some more thinking in this direction, it might begin to lead to that change we've been saying for so long that we've been wanting to make.    

 

 

 

 

 

The Work of Therapy:

Symptom Relief and Meaning-Making


Dr. christopher Emerson, Ph.D.By Dr. Chris Emerson 

 

 

 

 

One of the primary reasons people cite when seeking psychotherapy is a desire for relief from certain symptoms: the presence of anxiety in their daily lives, an ongoing experience of acute sadness and hopelessness, or problematic behavioral patterns that seem beyond the influence and control of ordinary will power. Others come to address more existential issues, or difficulties related to a particular phase of life: how to separate from the sometimes overwhelming influence of parents and move into a full, independent adulthood, or how to find meaning in challenging life experiences.

 

Most often, once the work of therapy begins and we probe deeply into the patient's experience, we find a combination of areas that deserve our attention. At that point, the work moves back and forth between achieving symptom relief and meaning-making: that is, we begin to see that the problems in living that we experience are multidimensional. They call out for examination and strategic problem-solving from more than one perspective.

Sometimes the need for a psychopharmacological solution becomes clear; medication is a useful and often necessary part of addressing particular difficulties once an informed diagnosis of certain conditions (e.g., bipolar disorder or attention deficit disorder) has been made. Other times, a person uses the setting of one-on-one "talk therapy" to revisit old, historical patterns of behavior with the therapist as a willing, interactive partner. Together, we work toward an experience of "repair" so that the patient can move into a future free of unsuccessful and limiting beliefs, behaviors, and patterns of relationship.

Whether one is searching for meaning, symptom relief or a combination of both, psychotherapy is worth considering as a "lever" for change. But psychotherapy is not a panacea, nor is it necessarily the most appropriate approach to every life situation for every individual. It's not unusual for me to work with patients in combining therapy with other transformative activities; for many people seeking recovery from drug and alcohol abuse, for example, psychotherapy is an adjunct to 12-Step work or stays in a rehabilitation facility or hospital. And because some changes are manifested primarily in the body, exercise regimes, body-focused work, and stress relief strategies are sometimes most appropriate and immediate ways to facilitate change. In these instances, therapy is useful to encourage self-awareness along the way, and to provide a forum for the individual to assimilate the changes that occur.

It should be acceptable for psychotherapy to view itself as a useful adjunct, and not hold to a "be all, end all" perspective. Not everyone needs or desires psychotherapy; but for those of us who find the project of therapy exciting, challenging and effective, it's worth the struggle and the investment of time, energy and resources

 

 

 

 

In This Issue
-The Violation of Human Connection
-A Strengths-Based Approach
-The Work of Therapy
-Palm Springs Office

 

 

 

CWE in Palm Springs
CLICK TO ENLARGE

 

 

 

Visit us at our NEW OFFICE LOCATION in Palm Springs

 

 I have been spending more and more time in Palm Springs the past few years and finally decided to open a satellite practice office there to work with new and established patients in the area. The office is located at:

 

1900 E. Tahquitz Canyon Way

Suite C-3

Palm Springs, CA 92262 

 

If you're considering therapy and spend time in Los Angeles, and/or Palm Springs, visit my website (www.drchrisemerson.com) to set up a consultation. This is a new, exciting development and I hope to continue to grow in my personal and professional life as my practice expands. 

  

 

 

 


 
This concludes the eighth issue of our quarterly newsletter, TRANSFORMATIONS.
Feel free to forward TRANSFORMATIONS to friends and colleagues, and take a moment to check out our archive of past issues at www.drchrisemerson.com. As always, we create our newsletter for YOU, our friends and colleagues, and we welcome feedback, comments, questions, or a simple "Hello". We look forward to our next encounter - Thank you for reading! 
 

Best, 
 
 
Chris, Katie, and Dylan
 

 

Contact Us...

for appointments and comments

Dr. Chris Emerson: 
(310) 550-4560
www.drchrisemerson.com
 
Dr. Katie Barnes: 
(310) 684-3605


Dylan Maddalena, Editor:

[email protected]

(310) 550-4560

www.drchrisemerson.com

 

450 N. Robertson Blvd., 2nd Floor

West Hollywood, California 90048 

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